PCA3 molecular urine assay correlates with prostate cancer tumor volume: Implication in selecting candidates for active surveillance
PCA3 molecular urine assay correlates with prostate cancer tumor volume: Implication in selecting candidates for active surveillance
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DOI：
10.1016/j.juro.2008.01.013
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发表时间：
2008-05-01
影响因子：
6.6
通讯作者：
Babaian, R. Joseph
中科院分区：
文献类型：
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作者：
Nakanishi, Hiroyuki;Groskopf, Jack;Babaian, R. Joseph
目的：前列腺癌基因3（PCA 3）已显示出作为前列腺癌检测的分子标志物的前景。我们评估了尿PCA 3评分与前列腺切除术肿瘤体积和其他临床和病理features.Materials和Methods的关联：尿液标本收集后，直肠指检从59名男子预定前列腺活检和83名男子预定根治性前列腺切除术。96名男性的前列腺切除术结果可评价。用Gen-Probe 400系统定量PCA 3和前列腺特异性抗原mRNA。结果：前列腺活检阴性组（30例）和前列腺活检阳性组（29例）的前列腺特异性抗原mRNA/前列腺特异性抗原mRNA比值（PCA 3）有显著性差异（中位数分别为21.1和31.0，p = 0.029）。PCA 3评分与直肠癌切除术标本中的总肿瘤体积显著相关（r = 0.269，p = 0.008），也与直肠癌切除术Gleason评分相关（6 vs 7或更高，p = 0.005），但与其他临床和病理特征无关。当比较低体积/低级别癌症（主要肿瘤体积小于0.5 cc，Gleason评分6）和显著癌症时，PCA 3评分存在显著差异（p = 0.007）。在多变量分析中，PCA 3是直肠癌切除术中肿瘤总体积的最佳预测因子（p = 0.001）。受试者工作特征曲线分析显示，PCA 3评分能很好地区分小体积癌（肿瘤总体积小于0.5cc），曲线下面积为0.757。结论：PCA 3评分能根据肿瘤体积和Gleason评分对男性进行分层，对选择小体积/低级别癌有一定的临床应用价值。
Purpose: Prostate cancer gene 3 (PCA3) has shown promise as a molecular marker in prostate cancer detection. We assessed the association of urinary PCA3 score with prostatectomy tumor volume and other clinical and pathological features.Materials and Methods: Urine specimens were collected after digital rectal examination from 59 men scheduled for prostate biopsy and 83 men scheduled for radical prostatectomy. Prostatectomy findings were evaluable for 96 men. PCA3 and prostate specific antigen mRNAs were quantified with Gen-Probe DTS (R) 400 System. The PCA3 score was defined as the ratio of PCA3 mRNA/prostate specific antigen mRNA X 10(3).Results: The PCA3 score in men with negative biopsies (30) and positive biopsies (29) were significantly different (median 21.1 and 31.0, respectively, p = 0.029). The PCA3 score was significantly correlated with total tumor volume in prostatectomy specimens (r = 0.269, p = 0.008), and was also associated with prostatectomy Gleason score (6 vs 7 or greater, p = 0.005) but not with other clinical and pathological features. The PCA3 score was significantly different when comparing low volume/low grade cancer (dominant tumor volume less than 0.5 cc, Gleason score 6) and significant cancer (p = 0.007). On multivariate analysis PCA3 was the best predictor of total tumor volume in prostatectomy (p = 0.001). Receiver operating characteristic curve analysis showed that the PCA3 score could discriminate low volume cancer (total tumor volume less than 0.5 cc) well with area under the curve of 0.757.Conclusions: The PCA3 score appears to stratify men based on prostatectomy tumor volume and Gleason score, and may have clinical applicability in selecting men who have low volume/low grade cancer.